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Yamamoto K, Nakagawa K, Otsuka F. Idiopathic ventricular tachycardia detected after coronavirus disease 2019. J Gen Fam Med 2024; 25:164-165. [PMID: 38707697 PMCID: PMC11065143 DOI: 10.1002/jgf2.687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 03/04/2024] [Accepted: 03/08/2024] [Indexed: 05/07/2024] Open
Abstract
We present a 23-year-old woman with depression and long COVID in whom a diagnosis of idiopathic ventricular tachycardia (VT) was made. Although the relationship between idiopathic VT and long COVID remains unknown, this is the first report of idiopathic VT detected in a patient with long COVID.
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Affiliation(s)
- Koichiro Yamamoto
- Department of General Medicine, Okayama University Graduate School of MedicineDentistry and Pharmaceutical SciencesOkayamaJapan
| | - Koji Nakagawa
- Department of Cardiovascular MedicineOkayama University HospitalOkayamaJapan
| | - Fumio Otsuka
- Department of General Medicine, Okayama University Graduate School of MedicineDentistry and Pharmaceutical SciencesOkayamaJapan
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2
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Successful radiofrequency catheter ablation of idiopathic premature ventricular complexes originating from the outflow tract improves heart failure-related quality of life. J Interv Card Electrophysiol 2023; 66:363-372. [PMID: 35731329 DOI: 10.1007/s10840-022-01264-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 05/31/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND To investigate the effect of successful RFCA in patients with idiopathic outflow tract PVCs (OT-PVC) on left heart functions, neurohormonal activation, functional status, and heart failure-related quality of life (HFQoL), with an integrated approach. METHODS Patients with frequent OT-PVCs, determined by 12-lead surface ECG who underwent radiofrequency catheter ablation (RFCA) with an acute success, were prospectivelly enrolled. Left heart functions were evaluated with the use of transthoracic echocardiography, neurohormonal activation with N-terminal Pro-brain natriuretic peptide (BNP), functional class with New York Heart Association (NYHA) and 6-min walking distance (6MWD), and HFQoL with Minnesota Living with Heart Failure Questionnaire (MLHFQ), at baseline and at 6 months. RESULTS A total of 108 patients were included in this study (43 ± 12 years old, 56% male). Majority of the OT-PVCs originated from aortic valve and right ventricle outflow tract (44% and 37%, respectively). Total RF time was 216 ± 87 s. Major complication rate was 0.9%. Left ventricle (LV) ejection fraction increased from 47 ± 8 to 53 ± 6% at 6 months (p < 0.001). Neurohormonal activation was suppressed significantly (104 ± 69 to 83 ± 42, p < 0.001). Functional class improved with %NYHA-I patients increasing from 54 to 89% (p < 0.001) and 6MWD from 293 ± 73 to 335 ± 59 m (p < 0.001). MLHFQ score improved from 32 ± 9 to 23 ± 5 p < 0.001. In multivariable analysis, LV end-systolic diameter (LVESD) and 6MWD were independent predictors of improvement in MLHFQ (for LVESD Uβ: - 0.26, 95%CI [0.44-0.09], p < 0.004 and for 6MWD: 0.04, 95%CI [0.03-0.06], p < 0.001). CONCLUSIONS RFCA of OT-PVCs is associated with improved well-being of patients, determined by left heart functions, neurohormonal activation, functional class, and HFQoL.
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3
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Porcedda G, Brambilla A, Favilli S, Spaziani G, Mascia G, Giaccardi M. Frequent Ventricular Premature Beats in Children and Adolescents: Natural History and Relationship with Sport Activity in a Long-Term Follow-Up. Pediatr Cardiol 2020; 41:123-128. [PMID: 31712859 DOI: 10.1007/s00246-019-02233-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 10/25/2019] [Indexed: 02/07/2023]
Abstract
Premature ventricular complexes (PVCs) are frequently documented in children. To date, few studies report long-term follow-up in pediatric cohorts presenting with frequent PVCs. The aim of this study is to assess the clinical relevance and long-term outcomes of frequent PVCs (≥ 500/24 h) in a large pediatric cohort. From 1996 to 2016, we enrolled all consecutive patients evaluated at Anna Meyer Children Hospital for frequent PVCs. Symptomatic children were excluded together with those patients with known underlying heart diseases; thus, our final cohort of study included 103 patients (male 66%; mean age 11 ± 3.4 years), with a mean follow-up of 9.5 ± 5.5 years. All patients were submitted to complete non-invasive cardiologic evaluation. The mean number of PVCs at Holter Monitoring (HM) was 11,479 ± 13,147/24 h; couplets and/or triplets were observed in 5/103 (4.8%) cases; 3 patients (2.9%) presented runs of non-sustained ventricular tachycardia (NSVT). High-burden PVCs (> 30,000/24 h) was confirmed in 11/103 (10.6%) patients. During the follow-up, only five patients (4.8%) developed clinical symptoms (3 for palpitations, 1 myocardial dysfunction due to frequent PVCs and NTSV; 1 arrhythmogenic cardiomyopathy); no deaths occurred. Basal PVCs were still present in 45/103 (43.7%) patients. Our data suggest that frequent PVCs may be addressed as a benign condition and should not preclude sport participation if not associated with cardiac malformations, heart dysfunction, or cardiomyopathy. This seems to be true also in presence of very frequent/high-burden PVCs. Otherwise, a careful follow-up is mandatory since sport eligibility should be reconsidered in case of onset of symptoms and/or ECG/echocardiographic changes.
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Affiliation(s)
- Giulio Porcedda
- Pediatric Cardiology Unit, A. Meyer Hospital, Viale Pieraccini 24, 50139, Florence, Italy.
| | - Alice Brambilla
- Pediatric Cardiology Unit, A. Meyer Hospital, Viale Pieraccini 24, 50139, Florence, Italy
| | - Silvia Favilli
- Pediatric Cardiology Unit, A. Meyer Hospital, Viale Pieraccini 24, 50139, Florence, Italy
| | - Gaia Spaziani
- Pediatric Cardiology Unit, A. Meyer Hospital, Viale Pieraccini 24, 50139, Florence, Italy
| | - Giuseppe Mascia
- Cardiology and Electrophysiology Unit, S. M. Nuova Hospital, Florence, Italy
| | - Marzia Giaccardi
- Cardiology and Electrophysiology Unit, S. M. Nuova Hospital, Florence, Italy
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4
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Seyis S, Usalan AK, Rencuzogullari I, Kurmuş Ö, Gungen AC. The Effects of Continuous Positive Airway Pressure on Premature Ventricular Contractions and Ventricular Wall Stress in Patients with Heart Failure and Sleep Apnea. Can Respir J 2018; 2018:2027061. [PMID: 29623136 PMCID: PMC5829433 DOI: 10.1155/2018/2027061] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Revised: 11/05/2017] [Accepted: 01/09/2018] [Indexed: 11/18/2022] Open
Abstract
Background We aimed to investigate the effects of continuous positive airway pressure (CPAP) treatment on electrocardiography (ECG), premature ventricular contraction load on 24-hour Holter recordings, and implantable cardioverter defibrillator (ICD) shocks in patients with obstructive sleep apnea syndrome (OSAS) and heart failure. Methods Patients with heart failure and ICD and patients with newly diagnosed OSAS were divided into two groups according to CPAP treatment. To compare the impact of CPAP on ECG parameters, both baseline and 6-month ECG, 24-hour Holter ECG, ambulatory blood pressure monitoring, echocardiography, polysomnography, and laboratory parameters were collected. Results CPAP treatment significantly reduced the frequency of premature ventricular contractions, T-peak to T-end, corrected QT, corrected QT dispersion, and T-peak to T-end/corrected QT ratio in the study group (p < 0.001 for all). Although the baseline NT-pro-BNP levels were similar between study and control groups, after six months, the NT-pro-BNP levels of the study group were significantly lower than that of the control group (39.18 ± 7.57 versus 46.11 ± 7.65; p < 0.001). Conclusions CPAP treatment in patients with heart failure and ICD and in patients with newly diagnosed OSAS may have beneficial effects on premature ventricular contractions and electrocardiographic arrhythmia indices and NT-pro-BNP levels. However, these results are needed to be clarified with further studies.
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Affiliation(s)
- Sabri Seyis
- Department of Cardiology, Live Istinye University Hospital, Istanbul, Turkey
| | | | | | - Özge Kurmuş
- Department of Cardiology, Ufuk University, Ankara, Turkey
| | - Adil Can Gungen
- Department of Chest Disease, Live Istinye University Hospital, Istanbul, Turkey
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5
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Gong X, Qin S, Huang Z, Zhou N, Yang Z, Nie Z, Dai S, Yao R, Wei Z, Ge J, Su Y, Shu X. “Pacing Bigeminal”. Int Heart J 2016; 57:747-752. [DOI: 10.1536/ihj.16-043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Xue Gong
- Department of Echocardiography, Zhongshan Hospital, Fudan University
| | - Shengmei Qin
- Department of Cardiology, Zhongshan Hospital, Fudan University
| | - Zheyong Huang
- Department of Cardiology, Zhongshan Hospital, Fudan University
| | - Nianwei Zhou
- Department of Echocardiography, Zhongshan Hospital, Fudan University
| | - Zhaohua Yang
- Department of Cardiology Surgical, Zhongshan Hospital, Fudan University
| | - Zhenning Nie
- Department of Cardiology, Zhongshan Hospital, Fudan University
| | - Shimo Dai
- Department of Cardiology, Zhongshan Hospital, Fudan University
| | - Ruiming Yao
- Department of Cardiology, Zhongshan Hospital, Fudan University
| | | | - Junbo Ge
- Department of Cardiology, Zhongshan Hospital, Fudan University
| | - Yangang Su
- Department of Cardiology, Zhongshan Hospital, Fudan University
| | - Xianhong Shu
- Department of Echocardiography, Zhongshan Hospital, Fudan University
- Department of Cardiology, Zhongshan Hospital, Fudan University
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Xu W, Li M, Chen M, Yang B, Wang D, Kong X, Chen H, Ju W, Gu K, Cao K, Liu H, Jiang Q, Shi J, Cui Y, Wang H. Effect of burden and origin sites of premature ventricular contractions on left ventricular function by 7-day Holter monitor. J Biomed Res 2015; 29:465-74. [PMID: 26668581 PMCID: PMC4662208 DOI: 10.7555/jbr.29.20150032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 04/10/2015] [Accepted: 06/10/2015] [Indexed: 11/10/2022] Open
Abstract
Recent studies have shown that premature ventricular contractions (PVCs) could enlarge the heart, but its risk factors are incompletely understood as a single 24-hour recording cannot reflect the true PVC burden due to day-to-day variability. Our purpose was to investigate the effect of burden and origin sites on left ventricular (LV) function in patients with PVCs by 7-day Holter electrocardiography (ECG). From May 2012 to August 2013, 112 consecutive patients with PVCs were recruited from the authors' affiliated hospital. All patients received 2-dimensional transthoracic echocardiography, 12-lead routing ECG and 7-days Holter ECG. Serum N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were measured. A total of 102 participants with PVCs were included in the final analysis. Origin of PVCs from the tricuspid annulus had the highest burden and NT-proBNP level. LV papillary muscle had a higher LV ejection fraction (EF) level and a lower LV end-systolic dimension (ESD) than other PVC foci (P<0.05). The high burden group had a higher LV end-diastolic dimension (EDD) and LVESD but lower LVEF than the other two groups (P<0.05). Female, older age, physical work, and history of PVCs had a significantly positive correlation with symptoms. Male, older age, physical work, and high burden were positive predictors of enlarged LVEDD, LVESD and higher serum NT-proBNP level, but lower LVEF. Seven-day dynamic ECG Holter monitor showed the true PVC burden on patients with PVCs. PVCs with a lower burden or origin from the LV papillary muscle and the fascicle were relatively benign, while PVCs with a higher burden or origin from the tricuspid annulus may lead to cardiac dysfunction.
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Affiliation(s)
- Wenhua Xu
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
| | - Mingfang Li
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
| | - Minglong Chen
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
| | - Bing Yang
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
| | - Daowu Wang
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
| | - Xiangqing Kong
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
| | - Hongwu Chen
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
| | - Weizhu Ju
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
| | - Kai Gu
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
| | - Kejiang Cao
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
| | - Hailei Liu
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
| | - Qi Jiang
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
| | - Jiaojiao Shi
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
| | - Yan Cui
- Nursing College of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
| | - Hong Wang
- Department of Respiratory, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
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7
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van Huls van Taxis CF, Piers SR, de Riva Silva M, Dekkers OM, Pijnappels DA, Schalij MJ, Wijnmaalen AP, Zeppenfeld K. Fatigue as Presenting Symptom and a High Burden of Premature Ventricular Contractions Are Independently Associated With Increased Ventricular Wall Stress in Patients With Normal Left Ventricular Function. Circ Arrhythm Electrophysiol 2015; 8:1452-9. [DOI: 10.1161/circep.115.003091] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Accepted: 09/02/2015] [Indexed: 11/16/2022]
Abstract
Background—
High idiopathic premature ventricular contractions (PVC) burden has been associated with PVC-induced cardiomyopathy. Patients may be symptomatic before left ventricular (LV) dysfunction develops. N-terminal pro–B-type natriuretic peptide (NT-proBNP) and circumferential end-systolic wall stress (cESS) on echocardiography are markers for increased ventricular wall stress. This study aimed to evaluate the relation between presenting symptoms, PVC burden, and increased ventricular wall stress in patients with frequent PVCs and preserved LV function.
Methods and Results—
Eighty-three patients (41 men; 49±15 years) with idiopathic PVCs and normal LV function referred for PVC ablation were included. Type of symptoms (palpitations, fatigue, and [near-]syncope), PVC burden on 24-hour Holter, NT-proBNP levels, and cESS on echocardiography were assessed before and 3 months after ablation. Sustained successful ablation was defined as ≥80% PVC burden reduction during follow-up. Patients were symptomatic for 24 months (Q1–Q3, 16–60); 73% reported palpitations, 47% fatigue, and 30% (near-)syncope. Baseline PVC burden was 23±13%, median NT-proBNP 92 pg/mL (Q1–Q3 50–156), and cESS 143±35 kdyne/cm
2
. Fatigue was associated with higher baseline NT-proBNP and cESS (
P
<0.001,
P
=0.011, respectively). After sustained successful ablation, achieved in 81%, NT-proBNP and cESS decreased significantly (
P
<0.001 and
P
=0.036, respectively). Fatigue was independently associated with a significantly larger reduction in NT-proBNP. In patients with nonsuccessful ablation, NT-proBNP and cESS remained unchanged.
Conclusions—
In patients with frequent PVCs and preserved LV function, fatigue was associated with higher baseline NT-proBNP and cESS, and with a significantly larger reduction in NT-proBNP after sustained successful ablation. These findings support a link between fatigue and PVC-induced increased ventricular wall stress, despite preserved LV function.
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Affiliation(s)
- Carine F.B. van Huls van Taxis
- From the Departments of Cardiology (C.F.B.v.H.v.T., S.R.D.P., M.d.R.S., D.A.P., M.J.S., A.P.W., K.Z.) and Clinical Epidemiology (O.M.D.), Leiden University Medical Center, Leiden, The Netherlands
| | - Sebastiaan R.D. Piers
- From the Departments of Cardiology (C.F.B.v.H.v.T., S.R.D.P., M.d.R.S., D.A.P., M.J.S., A.P.W., K.Z.) and Clinical Epidemiology (O.M.D.), Leiden University Medical Center, Leiden, The Netherlands
| | - Marta de Riva Silva
- From the Departments of Cardiology (C.F.B.v.H.v.T., S.R.D.P., M.d.R.S., D.A.P., M.J.S., A.P.W., K.Z.) and Clinical Epidemiology (O.M.D.), Leiden University Medical Center, Leiden, The Netherlands
| | - Olaf M. Dekkers
- From the Departments of Cardiology (C.F.B.v.H.v.T., S.R.D.P., M.d.R.S., D.A.P., M.J.S., A.P.W., K.Z.) and Clinical Epidemiology (O.M.D.), Leiden University Medical Center, Leiden, The Netherlands
| | - Daniël A. Pijnappels
- From the Departments of Cardiology (C.F.B.v.H.v.T., S.R.D.P., M.d.R.S., D.A.P., M.J.S., A.P.W., K.Z.) and Clinical Epidemiology (O.M.D.), Leiden University Medical Center, Leiden, The Netherlands
| | - Martin J. Schalij
- From the Departments of Cardiology (C.F.B.v.H.v.T., S.R.D.P., M.d.R.S., D.A.P., M.J.S., A.P.W., K.Z.) and Clinical Epidemiology (O.M.D.), Leiden University Medical Center, Leiden, The Netherlands
| | - Adrianus P. Wijnmaalen
- From the Departments of Cardiology (C.F.B.v.H.v.T., S.R.D.P., M.d.R.S., D.A.P., M.J.S., A.P.W., K.Z.) and Clinical Epidemiology (O.M.D.), Leiden University Medical Center, Leiden, The Netherlands
| | - Katja Zeppenfeld
- From the Departments of Cardiology (C.F.B.v.H.v.T., S.R.D.P., M.d.R.S., D.A.P., M.J.S., A.P.W., K.Z.) and Clinical Epidemiology (O.M.D.), Leiden University Medical Center, Leiden, The Netherlands
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8
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Sen-Chowdhry S, McKenna WJ. Are We Nearly There Yet Progress in the Prevention of Sudden Cardiac Death in the Young. Cardiology 2014; 127:265-74. [DOI: 10.1159/000357379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 11/11/2013] [Indexed: 01/28/2023]
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Pacchia CF, Akoum NW, Wasmund S, Hamdan MH. Atrial bigeminy results in decreased left ventricular function: an insight into the mechanism of PVC-induced cardiomyopathy. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2012; 35:1232-5. [PMID: 22845488 DOI: 10.1111/j.1540-8159.2012.03466.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Premature ventricular complexes have been recently recognized as a reversible cause of cardiomyopathy. The purpose of this study was to determine if premature complexes independent of "dyssynchrony" resulted in increased left ventricular (LV) dimensions and decreased LV function. METHODS Ten mongrel dogs underwent the implantation of a pacemaker and were randomized to a control group (n = 5) or a paced group (n = 5). In the paced group, the pacemaker was connected to two endocardial atrial leads, one inserted into the atrial port and the other one into the ventricular port with an atrioventricular delay adjusted to ensure the presence of coupled pacing simulating atrial bigeminy with conducted beats in the absence of aberrancy. Echocardiographic parameters of LV size (LV end-diastolic diameter [LV-EDD], LV end-systolic diameter [LV-ESD]), and LV ejection fraction (LVEF) were measured at baseline and after 4 weeks of monitoring (control group) or pacing (paced group). RESULTS In the control group, LV size decreased with no significant changes in LVEF: 55% at baseline versus 70% at 4 weeks (P = 0.23). In the paced group, LV-EDD decreased with no significant change in LV-ESD. Unlike the control group, LVEF decreased significantly from 69 ± 9% at baseline to 32 ± 22% after 4 weeks of pacing (P = 0.05). CONCLUSION We have shown that 4 weeks of coupled pacing simulating atrial bigeminy significantly reduced LV function. Our findings suggest that premature complexes independent of ventricular dyssynchrony might lead to the development of cardiomyopathy.
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Affiliation(s)
- Christina F Pacchia
- Department of Internal Medicine, University of Utah Health Sciences Center and Nora Eccles Harrison Cardiovascular Research and Training Institute, Salt Lake City, Utah, USA
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10
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Pfister R, Hagemeister J, Esser S, Hellmich M, Erdmann E, Schneider CA. NT-pro-BNP for diagnostic and prognostic evaluation in patients hospitalized for syncope. Int J Cardiol 2012; 155:268-72. [DOI: 10.1016/j.ijcard.2010.10.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2009] [Revised: 07/01/2010] [Accepted: 10/08/2010] [Indexed: 10/18/2022]
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11
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Wess G, Butz V, Mahling M, Hartmann K. Evaluation of N-terminal pro-B-type natriuretic peptide as a diagnostic marker of various stages of cardiomyopathy in Doberman Pinschers. Am J Vet Res 2011; 72:642-9. [PMID: 21529216 DOI: 10.2460/ajvr.72.5.642] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the diagnostic value of plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations in Doberman Pinschers in various stages of dilated cardiomyopathy (DCM). ANIMALS 328 Doberman Pinschers. PROCEDURES Staging of DCM was determined via analysis of results of physical examinations, 24-hour ambulatory ECG (Holter) recordings, and echocardiographic evaluations. Plasma samples for NT-proBNP assays were obtained at each examination. Concentrations of NT-proBNP were measured in 337 samples obtained from 196 healthy Doberman Pinschers (control dogs) and in 195 samples obtained from 132 Doberman Pinschers in various stages of DCM. These included dogs that had ventricular premature contractions (VPCs; 79 samples), echocardiographic changes (23 samples), or both (51 samples); 16 samples were from dogs with overt DCM, and 26 were from dogs that were considered normal during initial examination but developed DCM within 1.5 years after this assessment. Receiver operating characteristic curves were analyzed to determine sensitivity and specificity of NT-proBNP concentrations for detection of DCM. RESULTS NT-proBNP concentrations in dogs that had or developed DCM were significantly higher than those of control dogs. Sensitivity and specificity of NT-proBNP concentrations (cutoff value, > 400 pmol/L) to detect all stages of DCM were 81.1 % and 75.0%, respectively; sensitivity was 90.0% and specificity was 75.0% to predict echocardiographic changes. Specificity to detect echocardiographic changes was 90.4% at a cutoff value of 550 pmol/L. CONCLUSIONS AND CLINICAL RELEVANCE Plasma concentrations of NT-proBNP were increased in dogs with DCM and in apparently healthy dogs that developed DCM within 1.5 years after samples were obtained, compared with concentrations in control dogs.
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Affiliation(s)
- Gerhard Wess
- Clinic of Small Animal Medicine, Ludwig Maximilian University, 80539 Munich, Germany.
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Tanaka Y, Tada H, Ito S, Naito S, Higuchi K, Kumagai K, Hachiya H, Hirao K, Oshima S, Taniguchi K, Aonuma K, Isobe M. Gender and Age Differences in Candidates for Radiofrequency Catheter Ablation of Idiopathic Ventricular Arrhythmias. Circ J 2011; 75:1585-91. [DOI: 10.1253/circj.cj-10-0941] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Yasuaki Tanaka
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University
| | - Hiroshi Tada
- Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba
| | - Sachiko Ito
- Division of Cardiology, Gunma Prefectural Cardiovascular Center
| | - Shigeto Naito
- Division of Cardiology, Gunma Prefectural Cardiovascular Center
| | - Koji Higuchi
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University
| | - Koji Kumagai
- Division of Cardiology, Gunma Prefectural Cardiovascular Center
| | - Hitoshi Hachiya
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University
| | - Kenzo Hirao
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University
| | - Shigeru Oshima
- Division of Cardiology, Gunma Prefectural Cardiovascular Center
| | | | - Kazutaka Aonuma
- Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba
| | - Mitsuaki Isobe
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University
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13
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Akoum NW, Daccarett M, Wasmund SL, Hamdan MH. An animal model for ectopy-induced cardiomyopathy. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2010; 34:291-5. [PMID: 21070255 DOI: 10.1111/j.1540-8159.2010.02947.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Ectopy-induced cardiomyopathy is an increasingly recognized cause of reversible left ventricular (LV) dysfunction. The underlying mechanisms remain unknown. Our goal was to create an animal model for ectopy-induced cardiomyopathy. METHODS Eleven mongrel dogs underwent the implantation of a dual-chamber pacemaker. Four dogs served as the control group and seven as the paced group. In the paced group, the pacemaker was connected to two endocardial right ventricular leads, one inserted into the atrial port and the other one into the ventricular port with an atrioventricular delay adjusted to ensure the presence of coupled pacing simulating ventricular bigeminy. Echocardiographic measurements of LV size (LV end-diastolic diameter [LV-EDD], LV end-systolic diameter [LV-ESD]), LV ejection fraction (LVEF), and mitral regurgitation (MR) were obtained at baseline and after 4 weeks of monitoring or pacing in all dogs except one who had lead dislodgement. RESULTS In the control group (n = 4), no significant changes in LV dimensions or function were noted. In the paced group (n = 6), LV-EDD and LV-ESD increased from 3.58 ± 0.65 cm and 2.47 ± 0.55 cm to 4.15 ± 0.59 cm and 3.21 ± 0.47 cm, respectively (P < 0.01). In addition, LVEF decreased from 60 ± 7% to 46 ± 9% (P < 0.05). No changes in MR were noted. CONCLUSION We have shown that coupled pacing simulating ventricular bigeminy was feasible and resulted in increased LV dimensions and decreased LV function. By controlling the percentage of pacing, the coupling interval and the location of the pacing lead, this new model will allow the assessment of the relative roles of these variables in the development of ectopy-induced cardiomyopathy.
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Affiliation(s)
- Nazem W Akoum
- Nora Eccles Harrison Cardiovascular Research and Training Institute, Salt Lake City, Utah, USA
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Matsuo S, Yamane T, Hioki M, Narui R, Ito K, Tokuda M, Yamashita S, Yoshida H, Date T, Sugimoto KI, Yoshimura M. Acute progression of congestive heart failure during paroxysmal supraventricular tachycardia in a patient without structural heart disease. J Cardiol Cases 2009; 1:e133-e136. [PMID: 30615752 DOI: 10.1016/j.jccase.2009.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2009] [Revised: 10/26/2009] [Accepted: 11/02/2009] [Indexed: 10/20/2022] Open
Abstract
This report presents the case of a 48-year-old male with acute congestive heart failure caused by paroxysmal supraventricular tachycardia. The patient showed no structural heart disease with normal echocardiography parameters of the left ventricle. The pulmonary capillary wedge pressure (PCWP) was continuously monitored during the electrophysiological study. The PCWP and the plasma B-type natriuretic peptide increased from the normal range during ongoing tachycardia. The tachycardia was diagnosed as orthodromic atrioventricular reciprocating tachycardia and it was successfully eliminated by radiofrequency catheter ablation.
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Affiliation(s)
- Seiichiro Matsuo
- Department of Cardiology, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Teiichi Yamane
- Department of Cardiology, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Mika Hioki
- Department of Cardiology, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Ryohsuke Narui
- Department of Cardiology, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Keiichi Ito
- Department of Cardiology, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Michifumi Tokuda
- Department of Cardiology, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Seigo Yamashita
- Department of Cardiology, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Hiroshi Yoshida
- Department of Cardiology, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Taro Date
- Department of Cardiology, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Ken-Ichi Sugimoto
- Department of Cardiology, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Michihiro Yoshimura
- Department of Cardiology, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan
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15
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Mazurek B, Szydłowski L, Giec-Fuglewicz G, Markiewicz-Łoskot G. N-terminal prohormone brain natriuretic peptide-proBNP levels in ventricular arrhythmias in children. Clin Cardiol 2009; 32:690-4. [PMID: 20027660 PMCID: PMC6653564 DOI: 10.1002/clc.20611] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2009] [Accepted: 04/04/2009] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Ventricular arrhythmias are the most common consequences of structural and functional heart diseases, but cases with no evident pathology are also observed. A parameter indicating asymptomatic circulatory failure could support decisions related to possible treatment of ventricular arrhythmias. HYPOTHESIS The study objective was the evaluation of N-terminal prohormone brain natriuretic peptide (NT-proBNP) levels in children with ventricular arrhythmias and an attempt to determine if this parameter may be used for diagnosis and prognosis of ventricular arrhythmias. MATERIAL AND METHODS The study population was comprised of 36 children age 5 to 17.5 years old with idiopathic ventricular arrhythmias (Group B) graded mild or potentially malignant; 29 patients with mild ventricular arrhythmias were included into Group B1; and 7 patients with potentially malignant cases into Group B2. In all the patients, NT-proBNP assays were performed. RESULTS The NT-proBNP levels in Groups B, B1, B2 and the control group (Group K) were as follows: 41.5 +/- 15.1 pg/mL, 35.5 +/- 18.5 pg/mL, 66.3 +/- 24.9 pg/mL and 31.5 +/- 15.1 pg/mL, respectively. Between the groups with and without arrhythmias (Group B vs Group K), no statistically significant differences in NT-proBNP levels were found. However, markedly higher NT-proBNP levels were shown in the children with potentially malignant arrhythmias (Group B2) compared to the patients with mild arrhythmias (B1) and the control group (Group K). CONCLUSIONS The level of NT-proBNP increases with the severity of ventricular arrhythmia. NT-proBNP assays can be helpful for diagnosing and grading the severity of ventricular arrhythmias.
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Affiliation(s)
- Bogusław Mazurek
- Department of Pediatric Cardiology, Medical University of Silesia, Katowice, Poland.
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16
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Pfister R, Diedrichs H, Larbig R, Erdmann E, Schneider CA. NT-pro-BNP for differential diagnosis in patients with syncope. Int J Cardiol 2009; 133:51-4. [DOI: 10.1016/j.ijcard.2007.11.082] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2007] [Accepted: 11/18/2007] [Indexed: 10/22/2022]
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17
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Reversible cardiomyopathy provoked by focal ventricular arrhythmia originating from the base of the posterior papillary muscle. J Interv Card Electrophysiol 2009; 25:67-72. [DOI: 10.1007/s10840-008-9341-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2008] [Accepted: 11/05/2008] [Indexed: 10/21/2022]
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18
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Cakmak N, Sayar N, Cakmak M, Akyol A, Oguz E, Eksik A, Alper AT, Hasdemir H, Yilmaz H, Erdinler I. Effects of Radiofrequency Catheter Ablation on Myocardial Performance Index and Plasma NT-Pro-BNP Levels in Patients with Wolff-Parkinson-White Syndrome. Echocardiography 2008; 25:692-8. [DOI: 10.1111/j.1540-8175.2008.00669.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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